Advancement Flap for chronic fissure

Mucosal flap experience

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Advancement Flap for chronic fissure

Postby Suffering2long » 13 Apr 2021, 00:37

I thought I’d post about having an advancement flap procedure for a chronic fissure. My AF history is in the diary section. I don’t want to scare anyone off but if anyone wants a detailed, honest account of my experience with mucosal advancement flap surgery, keep reading.
I have waited a month to post anything because a) I was in too much pain to think about anything else other than recovery and b) I wanted to wait and see what would happen and if the pain would change so I could accurately describe the experience.
Firstly I was told the recovery would be “long” by the surgeon but didn’t ask for a specific time frame. The recovery has been a bit frustrating because I’m not sure what’s normal or not. I think I’ve read a hundred medical journals and forum posts about this. I was hungry for any information there was out there, which is limited at best.
After the surgery, I was told that the flap (inside anal canal) moved well. I was also given 60 units of Botox during op. I was in a lot of pain even with a nerve block in. I was then given fentanyl. Pain started to come back within the hour so the surgeon suggested staying in overnight to manage pain. Long story short, I should’ve just gone home where it is more comfortable. The nurses don’t really have knowledge of this sort of thing. They can really only offer you endone (constipating, I refused) or Panadol.
I left the next morning with Palexia (supposedly less constipating painkiller) & antibiotics. I had some Targin at home that came in handy over the following week.
The first week and a half the pain was like nothing I’d ever felt before. I’ve given birth 3 times with nothing more than gas and air so I can handle pain, but this is a 10/10 level. I needed those painkillers and took them around the clock. In between doses I was taking Panadol and Advil. It was still agony on the toilet. I thought I’m going to pass out or vomit and I dreaded going. No exaggeration.
I’ve felt so many sensations during this past month: nerve zaps, stinging, itch, throbbing, heavy dragging/pulling in pelvic floor. Coughing and sneezing was painful. The works really.
I religiously took showers after every BM and still am a month later. No toilet paper or wipes.
I also noticed that the first two weeks , I was going frequently to have a bowel movement. Like up to 7 times a day. I’ve since read that this is normal and I’m back to once or twice a day now. I’m on a high fibre diet, lots of fluids, movicol and normacol. I also supplement with magnesium, vitamin c and zinc.

The good news is the pain has lessened. It’s around a 3 out of 10. I can finally lie on my back. Still not bending, squatting or lifting anything. It is painful during and after BMs (more inside the anal canal) but manageable. I’m trying to get bowel movements softer as I think they are a bit too formed at the moment.

I have had minimal drainage. I only recently noticed after lightly dabbing the area that there was a tiny amount of fluid and it did have a slight odour that is reducing every day. Gross I know. Again I’ve read that’s normal too. It should only warrant more antibiotics if it’s hot, fever, oozing pus and not improving.

I’ve had a few spots of blood here and there but not enough to even wear a liner. At about 14 days I saw blood drip into the toilet and I got disappointed but this is all a normal part of recovery. It has been very much a two steps forward, one step back sort of thing.

I laid in bed on my side with a heat bag for the first two weeks. I barely got out. So if you need this operation, I’d suggest having a support person with you after. My husband has been a true angel. I’m a type A person that likes to do things myself and clean the house, be active, that sort of thing but I’ve had to let go!
I walked very slowly up the road on week 3 but felt sore afterwards.
I’m sure it will all be worth it to move on with my life. I’m just impatient with the slow recovery. I’ve read a lot of personal experiences with hemorroidectomy and this seems to be a similar recovery to that.
I will update at a later date with any new information. I have a follow up appointment next week. I’m hoping I can sit in the car by then.
Suffering2long
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Re: Advancement Flap for chronic fissure

Postby Conifer » 07 Oct 2021, 12:15

Hi Suffering2long

It’s been a number of months since you posted your story about this and I was just wondering how you were feeling now? I hope life has gotten easier and you are now managing without any pain.

Cx
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Re: Advancement Flap for chronic fissure

Postby Suffering2long » 07 Oct 2021, 17:45

Hi Conifer,
Yes, it’s been a while now. Things are going well mostly. The last month was almost 100%. I just had a mild soreness. Im not sure if it was in my head or not like a nerve pain response? No blood for about 3 months. Anyway I could manage that fine.
I got my period and a day before I saw a small amount of blood when I “wiped”. I say wiped but it’s more of a dab, then straight into the shower to rinse. I can feel something on the left side and I’m wondering if it’s scar tissue slightly opened or a hemorroid. I have had a swelling of tissue from the anus so it could be a swollen hemorroid.
I haven’t been to see the surgeon because I’m in a lockdown area. I will probably see her in November or December.
Suffering2long
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Re: Advancement Flap for chronic fissure

Postby Suffering2long » 07 Oct 2021, 17:47

Also I forgot to say thanks for your message. What’s happening with you? Are you considering a flap or lis?
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